Agenda item

Andy Hardy University Hospitals Coventry and Warwickshire (UHCW) will report at the meeting on:

The Board considered a progress report from Andy Hardy, University Hospitals Coventry and Warwickshire (UHCW) which provided an update on progress with the Sustainability and Transformation Plan (STP), with particular reference to the content and progress with the individual work streams.

Urgent and Emergency Care

The current work stream priority was right sizing hospital urgent and emergency care systems in the context of changes driven through other work streams and the national Urgent and Emergency Care Plan. It was anticipated that the proposed model of Urgent and Emergency Care would be presented to the STP Design Authority for internal clinical agreement in the autumn of 2017.

The Board were informed that the Coventry and Warwickshire Stroke Programme was at the pre-consultation stage, with the pre-consultation Business Case within the NHS England assurance process. It was anticipated that this would go to an Assurance Panel in the early summer.

Planned Care

The report informed that the current work stream focus was on the first elective pathway review, muscular-skeletal, with emphasis being on hip and knee replacements with a view to start to change in practice during 2017. A Clinical Reference Group had been established and had met several times and a clinical workshop was planned for April/May. A revised MSK pathway was now in place in North Warwickshire and, subject to approval, was due to start in Coventry at the end of quarter 1 2017. The review/ revision of other elective pathways would follow in quarterly waves including General Surgery, ENT, Ophthalmology, Specialist Surgery and other smaller specialities. Following pathway redesign, policies would be revisited.

In relation to cancer care, work was underway to achieve the cancer 38 day target.

Maternity and Paediatrics

Work was underway to refocus the work stream’s programme in line with the national ‘Better Births’ strategy. A work stream ‘away day’ had been arranged for April.

Proactive and Preventative Care

The Out of Hospital Programme was progressing to plan with proposals developed by providers currently undergoing commissioner moderation, prior to a decision on procurement. The scope of the programme beyond the Out of Hospital was much broader and was currently being developed. The Board noted that this offered the major interface with Health and Wellbeing Boards and Local Authority led services relating to the promotion of healthy lifestyles and the building of community capacity. These were also key features of Health and Wellbeing Strategies and emerging transformational plans for local authorities. Reference was made to the three steps to be undertaken to support prevention. To date efforts had focused on the first phase in terms of developing an understanding of the level and nature of work in the system. To succeed prevention needed to feature in every element of work and become ‘everybody’s business’. 

Productivity and Efficiency

Progress in this area had been slow. Individual organisations had just received feedback from the National Benchmarking and this was currently being collated to give an STP wide picture, so organisational differences could be examined.

Andy Hardy informed the Board of the recent appointment of Brenda Howard as the Programme Director. She would be establishing a Programme Management Team and would establish systems and processes to oversee progress and delivery of the STP. The programme team would be supporting the work streams to deliver their priorities. The Board were also informed about the new guidance from NHS England concerning next steps on the Five Year Forward View and STPs.

Members of the Board raised a number of issues in response to the report including:

·  How the Programme Director post was funded and the actual costs involved

·  Clarification about the ‘Big Conversation’ phase on pre-consultation relating to maternity care that had been due to commence at the end of November (Minute 112 below refers)

·  Further information about the latest position relating to the proposals for stroke services which was with NHS England for assurance

·  Clarification about the timings and schedules of the individual work streams and whether there had been delays

·  Whether the STP would work in isolation or whether there would be implications for the STP if other STPs from the surrounding areas had failings

·  The links between the individual work streams

·  Further information about the thresholds and proposals for hip and knee replacements

·  Support for all the hard work involved with progressing the STP work streams

·  The importance of ensuring successful communication with the public when progressing the work streams including consideration of the terminology to be used.

Professor Guy Daly informed the Board about the work of the STP Design Authority and suggested that a report including the terms of reference and membership be submitted to a future meeting. He recommended that members be provided with a copy of the update on the Five Year Forward View. 

RESOLVED that:

(1) The report be noted and the direction of travel for the STP be supported.

(2) A report on the STP Design Authority be submitted to a future meeting.

(3) The update on the Five Year Forward View be circulated to Members.